General diet for pregnancy
Eating healthily during pregnancy is important for the mum’s health and the health of the offspring. Issues to particularly watch are weight gain (ensuring it is adequate but not excessive as that can cause problems for the baby and for mum and getting adequate nutrients.
HEALTHY EATING guidelines apply to pregnancy too such as having some starchy food, preferably wholegrain, with each meal, watching the amount of salt and saturated fat in the diet. Alcohol is a poison which crosses the placenta. Excess consumption can damage the baby so women need to try and cut down as much as possible so that no more than 1 unit a day is consumed.
NUTRIENTS TO PAY PARTICULAR ATTENTION TO DURING PREGNANCY
Calcium and vitamin D
This is particularly important during the 3rd trimester when the baby’s bones are growing rapidly. At this stage the mother’s supplies may be diminished and so lead to poor teeth and osteoporosis. Good sources are milk and dairy products, these are the best absorbed, or fish bones (e.g. sardines) and foods that contain baking powder (calcium carbonate) such as scones.
Vitamin D is needed to absorb calcium and this is found in margarine, eggs and oily fish . It is also produced by the body when sunlight falls on the skin. To safeguard vitamin D intake pregnant women should take a 10 mcg supplement of vitamin D daily
This is required by both mum and the developing foetus. Sources include red meat, pulses, green leafy vegetables and fortified breakfast cereals. Iron sources which are not from meat need Vitamin C for absorption. Avoid drinking tea or coffee with a meal as the tannins in them will inhibit iron absorption.
In the first three months of pregnancy this vitamin has recently been shown to reduce the incidence of neural tube defects such as spinabifida and hydrocephalus. For this reason it is recommended as a supplement preconceptionaly and up to 12 weeks of pregnancy. (N.T.D. is a rare condition. If you are over 12 weeks pregnancy you will be asked to take the supplement if you plan another pregnancy. The dose required is 0.4mg which can be obtained from a chemist or health food shop or ask your G.P. In addition to this supplement a good dietary source of 0.2mg of folic acid is recommended. In the last trimester folic acid is required in adequate doses as it is taken up by the foetus; shortages may lead to a form of anaemia. Sources include lettuce, raw or lightly cooked green leafy vegetables, fortified breakfast cereals, bread, potatoes, yeast extract, nuts and fruit. It is a delicate vitamin and so easily destroyed. Steamed, stir-fried and microwave vegetables cooked for a short time loose less vitamins. Poor or long storage of fruit and vegetables will also cause loss of valuable vitamins including folic acid.
PROBLEMS RELATED TO DIET DURING PREGNANCY.
Nausea This is common from around 6-9 weeks up to about 16 weeks but it can occur from 2 weeks right through to the end (this is rare) As it is often worse when the tummy is empty the solution is to consume starchy snacks. A couple of semi sweet biscuits before rising may alleviate morning sickness. See overhead transparency 3:3 for suggestions of starchy snacks. Other suggestions to relieve nausea include avoiding strong smells, including perfumed. If smell of cooking affects you then get someone else to cook or eat cold food. Travelling may make the nausea worse. Small frequent meals are best.
This happens due to the decrease in gut mobility caused by the pregnancy hormones. If on Iron supplements this can also give rise to constipation The solution is to ensure that there is adequate fibre in the diet and to drink sufficient fluid (about 8 cups a day) Gentle exercise encourages gut mobility too.
This may occur as the baby gets larger and pushes against the tummy. It can also occur due to decreased muscle tone and can start from about 3 months onwards. Solutions are to eat little and often. Eating yoghurt and milk may help. Relax and sit up during meal times. Avoid lying down for an hour or so after eating and so don’t eat a big meal too soon before going to bed. Spicy foods may cause heartburn as may fatty foods, citrus fruits and fizzy drinks.
A pregnant mum is more susceptible to food poisoning and some of the food born organisms can be dangerous and even life threatening to the unborn child. So it is worth taking extra care.
1 Eat food within its “consume by” date
2 Follow correct microwave procedures to avoid uncooked cold spots such as stirring food half way through cooking and allowing standing times.
3 Buy a fridge thermometer and make sure the temperature remains between 1-4 degrees C
4 Allow foods to cool quickly and then cover and store in the fridge. Do not re-heat cooked food more than once
5 Cooked and raw food should be stored separately.
6 Cook all meat thoroughly, not just pork and chicken
7 Wash all fruit and vegetables thoroughly before eating.
Listeria may cause miscarriage and still births. To avoid do not consume soft cheeses and blue veined cheeses. Eat no meat and fish pates and pastes except for the tinned sort.
Salmonella will make the individual feel very unwell with violent sickness and diarrhoea. It can be carried in the blood and cause infection in others for months afterwards. To avoid do not consume raw or runny eggs. Do not consume dishes containing raw eggs.
Toxoplasmosis can affect the unborn child and symptoms may vary from hydrocephalus to retina damage and it may also cause miscarriage. It is carried by the cat and can be spread via its faeces. Therefore always wash hands after handling a cat and avoid having to empty its litter tray. Always wear gloves while gardening and wash hands thoroughly afterwards. As with general food hygiene it is important to wash all fruit and vegetables and as the organism can live in all meats it is important to cook all meat thoroughly. Avoid unpasteurized milk and its products, this includes goats and sheeps milk.
Special Warning about Liver and liver prodcts
Animals store a very high amount of Vitamin A in their liver so that as it is a fat soluble vitamin and not easily excreted a pregnant women consuming this amount of vitamin a may cause a high toxic level to be passed to the foetus. In turn this may cause birth defects This is very rare and it is only habitual consumption which has caused the problems. However it is best avoided altogether along with liver products such as pates and liver sausage, Rich Vitamin A sources are best avoided too such as Cod liver oil. However the quantity of Vitamin A in an ordinary multivitamin is safe.
There is no need to eat for two but on the other hand restricting weight gain may result in a weak low birth weight baby. Let your appetite be a guide. During pregnancy the metabolism slows down and mum is generally less active . The body becomes more efficient at absorbing vitamins too. So on average only about an extra 200 kCals is needed in the last trimester of pregnancy.
The average weight gain is 10-12 kg (11/2-2 stone) 8lbs is gained during the first 20 weeks and then an average of 1 lb a week If you are overweight at the start of pregnancy then weight still needs to be gained but only about 1 stone. If you are under weight at the start of pregnancy then more than the average amount of weight needs to be gained to ensure baby is a good weight at birth i.e. about 2.5 stone
Excess weight gain could give rise to gestational diabetes and the problems associated with that, such as a large baby which is difficult to deliver. It could also cause a rise in blood pressure and also cause long term obesity. A little excess weight gain may be lost by breast feeding. It is best to concentrate on eating nutrient dense foods and not those that provide “empty calories” Recent research has also shown that if a mother gains excess weight during pregnancy she can pass on a tendency to diabetes and obesity to her offspring